Wednesday, October 18, 2017

Perhaps the most frustrating aspect of healthcare reform is the fact it has little to do with the delivery of healthcare. read any article or proposed legislation and you will find plenty of information about Insurance, money, and the uninsured: almost nothing about delivering healthcare to the underserved.

In an October 13, 2017, Press Release, The AmericanPsychological Association APA President Antonio E. Puente said, “This move, coming hours after the president issued an executive order to allow trade associations and other groups to offer their own health plans, will wreak havoc on the health insurance markets". There it is; it is about the health insurance markets.I agree the availability of mental health services is atrocious, at best, for a highly developed nation like the United States. My theory is no one wants to talk about it because: 1) it can be an uncomfortable subject, 2) It would add a great deal of expense to the healthcare basket, 3) It is misunderstood. I also understand the position of the Mental heal providers. The service is vital and almost no one is paying for it. I am an advocate of improving the delivery and quality of healthcare. As a nation, we just cannot seem to get past the money part. Population Health is in its infancy, although some providers have made great strides. However, Population Health is often misunderstood: and who wants to deal with the "uninsured' population? Let me share a little-known secret about the Affordable Care Act (ACA). a family of 2 who does not make between 100 and 400 percent of the Federal poverty wage ($16,700) annually IS NOT ELIGIBLE FOR A SUBSIDY! That is correct, if you make $12,500.00 per year, the only thing you are eligible for is a tax waiver (thanks a lot) or an open market policy (which you could get anyway) which you cannot afford. I looked and the least expensive policy available and It was around $1080 per month with a $12,000.00 deductible. You do the math: it does not work. President Trump stopped subsidies to INsurance companies. Lamar Alexander (R) and Patty Murry (D) worked together to thwart that effort. When it comes to Healthcare, bottom-line is politicians have no idea what to do! Talk to you elected representatives.

Tuesday, October 10, 2017

Not so Fast: I Feel Your Pain!

As I began this blog post, I had a certain theme in mind. Then, as is often the case, opened the October issue of a magazine which I read on a regular basis. Everything changed. In the October 2017 issue of Fast Company magazine, there begins a theme on empathy. Empathy in the corporate world, the executive suite, and the cafeteria (for those companies who still have cafeteria's).

The editor began the discourse on empathy right up front. Why was I drawn to this particular subject? Why write about it? Perhaps it is because I have been accused, long in the past, of not showing any! This from the person who eventually became CEO of the company and promptly proceeded with a house cleaning of executives that rivaled The Great Purge of Stalinist Russia, but I digress a bit. Empathy is a good thing and I wholeheartedly support it. Even when it is espoused by those who have no earthly, or comic for that matter, idea how to practice it. It is always easier to call out the other guy as non-empathetic. Thus the 'Yield Sign'. Hold on a minute. Spoiler Alert, your new star galaxy enabled phone will not help you practice empathy.

I know, you are shocked to hear this. After all, you paid a small fortune for the latest techno gadget. But it cannot do the one thing only humans can do: more specifically the human known as YOU. Ok, you say, so how do I become more empathetic? Come to think of it why would I want to? Well, like anything else written by the journalistic mash of "let us tell you how to be successful" individuals, it is useful. Just be careful what you take for fact.

A High Performing leader must be able to connect. It is that simple. If you can not connect, you cannot lead, and you sure as heck cannot express empathy in a believable way. Unfortunately, for decades business executives, hospital executives, and academics were taught, and have taught, to show empathy is a weakness. 'Au Contraire'! In fact, I believe it shows courage and the ability to be a transformative leader.

As Fast Company points out, Satya Nadella, CEO of Microsoft, has shown empathy to be a very effective tool. Expressing empathy is a skill which can be taught and learned by anyone. To make it sincere is up to the individual. Edward Hallowell, M.D. (2011) expressed, "Connected organizations thrive; disconnected ones perish" (p. 107).

The team at High Performance Solutions Group can help you and your organization to express empathy and enhance both personal and organizational success. Think about it. How many companies can you name which no longer exist because they could not connect to employees? The list is long: don't become a part of it!

Wednesday, October 4, 2017

The first tweets about the massacre in Las Vegas were ostensibly about the issue of Gun Control. Often couched in terms of "gun violence", I must take issue and point out guns are inanimate objects: they cannot commit violence. Additionally, we have seen numerous news stories talk of the gunman when the conversation we should be having is one about Mental Health! This man was not a "gunman", he was a "psychopath". Yet we have heard very little about the state of mental health services.

Anyone who has been around healthcare for any time is aware of the dismal state of mental health in our country. The National Alliance on Mental Illness (NAMI) noted, "Only 41% of adults in the U.S. with a mental condition received mental health services within the past year. Among adults with a serious mental illness, 62.9% received mental health services in the past year". (www.nami.org). Almost 40 % of adults with a serious mental illness went untreated!

Catch the issues early experts say. However, NAMI reports, "Seventy percent of youth in juvenile justice systems have at least one mental condition and at least 20 percent live with a serious mental illness". Let me say that again, Twenty percent of our YOUTH LIVE WITH A SERIOUS MENTAL ILLNESS!

So we have yet another horrific wake-up call about the ugliness of our mental health system and politicians want to talk about guns. Do we have our priorities straight? I am not so sure.

Las Vegas Massacre: What Indicators Were Missed?

Las Vegas Massacre: What Indicators Were Missed?

As the facts continue to come out about the shooter in the Las Vegas massacre, the things we know now are that it took an extensive amount of planning to carry out such a nefarious attack. Currently, at least 59 people have been killed, over 500 hospitalized and 23 firearms were found stashed in gunman Stephen Paddock’s hotel room. The rifles and caliber of ammunition were .308 and .223, the kind of ammo that would be used in small and big game hunting. It’s hard to imagine, based on what we know now, that somebody did not notice key indicators leading up to the tragedy

The 32nd floor of the Mandalay Bay Hotel provided the perfect overlook for the madman to carry his act out on concertgoers. In reviewing video coverage of the incident, the hotel sits prominently in the foreground of the venue. Apparently, the gunman checked into the room from where the shooting took place last Thursday, September 28. Although initial reports indicate that Paddock acted alone, it is a way to early to confirm this or speculate on what, if any connections he had to other groups. ISIS came out early taking credit, stating that he is a Muslim convert. So far, this has been discounted by the FBI, but it is still too early to draw conclusions. They may not be calling it an act of terrorism in the traditional sense, but it certainly was an act of terror.

Hotels and concert venues represent very soft targets for those who wish to carry out these kinds of acts. They are like churches, theaters, stadiums, shopping centers and mass transit stations in terms of the ease of planning and the challenge of detection. Any place where there are multiple points of entry and egress and where there are large crowds increase the risk of these kinds of incidents. It is hard to imagine that somebody didn’t notice something suspicious about Stephen Paddock in the days and weeks leading up to the massacre. His actions were well planned. He was able to stockpile an arsenal of weapons and ammo in the few days leading up to the attack. Someone had to notice something unusual about him, the way he might have been acting or things that he might have said, etc. Aegis Protective Services lists 7 possible signs of a workplace shooter. This was not a workplace shooting but the traits would fit many active shooters and terrorist characteristics and perhaps Paddock exhibited some of these. The 7 possible Signsare:

1. Bullying/Intimidating Behavior

2. Paranoia or Conflicts with Others

3. Obsession with Weapons

4. Deteriorating Work Habits

5. Significant Personal Problems

6. Poor Social Skills or Antisocial Attitudes

7. Argumentative Behavior

One has to go backward from the event and “reverse engineer” the incident to determine what the indicators were that could have prevented this. Also, it would help to take some pointers from the Israelis who have the best counter-terrorism program in the world in reducing the risk of mass casualty situations like we witnessed last night.

After the November 2015 Paris massacre by ISIS terrorists, there was an article published in Real Clear Worldabout the threat of violence and terrorism that the Israelis live with every day, and their effective strategies and tactics for countering the threat. The article states the importance of a vigilant and aware public and outstanding intelligence cooperation. While not everything the Israelis implement would work in our society, there are some venues, especially the ones where large crowds gather, where it might make sense to take lessons from the Israelis on perimeter security, defense, and rapid response.